Individual provider Active NPI

Jacqueline J. Greene, M.D.

  • Otolaryngology Physician
  • San Diego, CA
National Provider Identifier
1144583931
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A16242 Issued in CA
Practice address
3030 Childrens Way
San Diego, CA 92123-4232
Phone
(858) 309-7701
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 125.061876 IL
Otolaryngology Physician 207Y00000X A16242 CA Primary

Addresses

Primary practice location

3030 Childrens Way
San Diego, CA 92123-4232

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201106002548 CA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 9436454048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of California, San Diego School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A16242CAMDOtolaryngology Physician
125.061876ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Jun 1, 2025 Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince May 2, 2023 Accepting new patients
Regents of the University of California CurrentSince May 2, 2023 Accepting new patients
Regents of the University of California Current Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Jun 1, 2025 Accepting new patients
Regents of the University of California Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince May 25, 2025 Accepting new patients

Locations

9400 Campus Point Dr
La Jolla, CA 92093
Phone (858) 249-3800

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583

3855 Health Sciences Dr
La Jolla, CA 92093
Phone (858) 822-6094

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

3030 Childrens Way
San Diego, CA 92123
Phone (858) 966-4003

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

8899 University Center Ln
San Diego, CA 92122
Phone (858) 543-7496

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1144583931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234232",
            "telephone_number": "858-309-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JACQUELINE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "125.061876",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A16242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.